Wednesday, April 22, 2015

Lab Accreditation In India


In this and few coming posts I have decided to review few questions from last few years’ final exam papers. Today's topic is lab accreditation in India.
Laboratories are integral part of a health care system, they play crucial role in diagnosis, treatment, monitoring, prognosis of the disease process, and clinical research.  That is why accurate test results are critical each and every time the tests are conducted, and they should be accurate, reliable and reproducible.  This can be only achieved if good laboratory practices are observed. This is when accreditation comes in play.
Scenario in India: The exact number of laboratories, which exist in the country, is not known. Rough estimates show that there are some one lakh medical diagnostic laboratories in the country.  NABL has accredited around 450 medical laboratories (0.45%), with the rest (99.55%) having only registered themselves with the respective state health departments.
Accreditation Definition: The concept of laboratory accreditation was developed to provide third-party certification that a laboratory is competent to perform the specific test or type of tests. It is the formal recognition, authorization and registration of a laboratory that has demonstrated its capability, competence and credibility to carry out the tasks it is claiming to be able to do. It provides feedback to laboratories as to whether they are performing their work in accordance with international criteria for technical competence.

NABL: NABL was established with the objective to provide a scheme for third-party assessment of testing, & calibration labs later on extended its services to the clinical laboratories in our country. The Program started in 1981and is registered as an autonomous body under the Societies Act in 1998 signatory to APLAC/ILAC. The international standard currently followed by NABL specific for medical laboratories is ISO 15189 and NABL 112 specific guidelines.
As per ISO 15189, 2007 international standard has five clauses which include 1. Scope2. Normative references, 3.Terms and definations4. Management requirements and technical requirements, it has three appendices and one of which is ethics.
NABL 112 recommends guidelines that are complied with and over above ISO 15189 and recommend to define local Indian and state regulations ex. Notifiable disease, bio waste management, classification of labs , retention times for specimens,  and regulatory signatures.
NABL gives accreditation for certified scope only, reaccreditation needs to be done in 2 years and unauthorized use can lead to suspension of the accreditation.
Benefits of Lab accreditation:

1.       Independent certification of lab competence

2.       Improves lab performance

3.       Increases client confidence

4.       Makes the lab conscious of quality

5.       Increase laboratory competitiveness.

6.       Build staff morale

7.       Improves lab prospects.
 
Presently, NABL accreditation is voluntary. Ministry of Health has mandated NABL accreditation for all medical laboratories empanelled by CGHS and the laboratories under Centre and State Govt. hospitals.  Clinical establishment act has been implemented in many states of country that will make the exact total number of the diagnostic laboratories evident as registration is mandatory and will lead to shift of the labs from unorganized to organized sector.
      References:
   1. Ramesh Adige, Indian health sector needs accreditation for medical laboratories,
   2. Indian Journal of Clinical Biochemistry, 2005, 20 (2) 186-188, A.S .Kanagasabapathy and Pragna Rao,laboratory accreditation - procedural guidelines
Further Reading:
 

 


 

Theory Paper- June 2012



 


Theory Paper 2,3 and 4- December- 2011




Theory Paper 1 - December- 2011

1. Classify  glomerular  diseases.  Discuss  the  immune  and  non-immune  pathogenesis  of  glomerulonephritis.

2. a.  Classify  vasculitis.
    b.  Describe  the  pathology  of  small  vessel  vasculitis.

3.  a.  Mention  the  common  site  of  origin  of  osteogenic  sarcoma.
     b.  Describe  the  different  histological  subtypes  of  osteogenic sarcoma.

4.  a.  Define  cirrhosis.
     b.  Enumerate  the  causes  of  cirrhosis.
     c.  Describe  the  method  of evaluation  of core  biopsy  of liver  in cirrhosis.

5.  a.  Write  down  the  pathogenesis  of  celiac  disease.
     b.  Describe  the  pathological  features  of  this  disease.

6.  a.  Classify  interstitial  pneumonias.
     b.  Describe  the  pathology  of  usual  interstitial  pneumonia.

7.  a.  Enumerate  the  different histological  subtypes  of  breast carcinoma.
     b.  Discuss  the  prognostic  factors  of  breast  carcinoma.

8.  Describe  the  immunophenotypic  and  cytogenetic  changes  of peripheral  B  cell  neoplasms.

9.  Describe  the  cutaneous  manifestations  and  chromosomal
aberrations  in  familial  cancer  syndromes.

10.  Describe  the  pathogenesis  and  pathology  of  Grave's  disease.

Monday, August 12, 2013

MICROTOMES, KNIVES, HONING AND STROPPING


One of the high yield topic in the practicals is MICROTOMES and KNIVES.
Important aspect of the practicals is to know about thsese minor things but they really do ask about all of these in exams.

I have added few frequently asked questions.

1.What is honing?
2.What are the types of hones used in histopathology lab?
3.What are the grades of honing?
4.What are the types of abrasives used in honing of the knife?
5.What are the precautions taken to protect the handling and use of the knife?
6.What are the lubricants used for honing of knife?
7.The diffrent angles of the knives
8. About Honing and stropping
9. Faults in section cutting- reason and remedy.


 

National Board Guidelines for Pathology Theory and Practical Examinations.











 

Monday, May 9, 2011

Use of Internet

                I think now a days internet is great source of material which will be required for D.N.B students. As we all know pathology is very vast field and we are supposed to know lot of things. But internet made it easy.. you can achive lot of things like just from downloading the books, to digitil pathology slides, seminars, power point presentations, telepathology slides, leactures etc in each subspeciality of pathology.

                 So what we have to do is from this huge collection we have to pick the selective things from the internet and save them in one file so that we can read those things,listen to the lectures,or watch the slides of our intrest and which are usefull for our examination.

                 Like for example, Robbins is must read book but sometimes you don't feel like reading and you feel like somebody should teach us like they use to in our undergraduation. So here you go...

http://www.medicalschoolpathology.com/PPTsLEC.htm

These are lectures on General Pathology by Dr.John Minarcik and they are really useful for theory as well as practical preparation. So like this you can keep adding to this links like this and just keep revising the stuff and try to find the answers.